09/12/2014
Jorge Vazquez, pharmacist and PhD from the University of Valladolid. Expertise in strategic initiatives for health-care
The social and demographic changes taking place in society today are shifting the requirements demanded from public health-care systems. The ageing of the population and the development of the prototype of predominant diseases, from acute to chronic, require systems to adapt in order to continue providing adequate and efficient medical care while attempting to keep their sustainability.
Spain is one of the countries with the highest pressure on the demand for health-care resources and financing capacity. This has led to a marked tendency for a comprehensive rethinking of the delivery model, by focusing the priority on the optimisation of the use of resources to meet the growing demand for the coming years.
These demands will require changes in most of the features that make up the system, from the role of the patient to the activities to be performed by health-care workers, not to mention changes in health-care policies and the governance thereof. The study and robust development of a social-health-care space will be key in the strengthening of our Welfare State.
Life expectancy of the Spanish population has increased significantly in recent decades, currently set in 82.84 years on average for both sexes (79.99 years for men and 85.61 for women; INE 2013). Moreover, we know that in our country chronic diseases account for more than 70% of the health-care budget, partly due to the need of repeated hospitalisations, and it is estimated that the evolution of the population over 65 years in Europe will exceed 25% around 2050, a horizon that, according to experts, requires the implementation of comprehensive and cross-section plans.
Evolution and Life Expectancy Forecast
Source: INE, 2012-2021: Population forecasts. Parameters of demographic change.
In an effort to work on finding a sustainable and realistic health-care future, the patient will assume greater responsibility for managing their own health and will have to look after their own behaviour, lifestyle, diet, drug therapy compliance and a number of practises that up to now only involved primary health-care workers. Therefore, the segmentation of patients will be key in an environment where the focus will change from the disease to the patient, to maximise the potential benefit of a therapeutic strategy for each individual. The real value of these therapeutic solutions must not only be demonstrated in clinical studies but also in the practical conditions of everyday life. The management of patient care will be a shared responsibility between all actors, which must also be willing to share the risks.
This ageing of the population and its subsequent result in the growing of patients' empowerment, will entail a major challenge for societies moving toward a new health-care model, at European level known as 'Horizon 2020'.
However, in opposition to widespread fears that ageing will cause the destabilisation of the Welfare State, we must not forget that the increase in life expectancy is a triumph in the health-care results of developed societies and, as such, it should be addressed not questioned.